EVOLVE HESI PHARM COMPREHENSIVE TEST
PAPER Question and Answer 2026 | Complete
Exam Review Guide | Grade A+
• A male client who has been receiving an antineoplastic drug has
developed thrombocytopenia. What instructions should the practical
nurse (PN) reinforce?
A) Use suppository form of drugs.
B) Avoid large public gatherings.
C) Rise slowly when standing up.
D) Shave with an electric razor. -✓✓D) Shave with an electric razor.
Feedback:
Thrombocytopenia is a common side effect of bone marrow depression
caused by several antineoplastic agents. The client is experiencing a low
platelet count and should use an electric razor (D) to reduce his risk of
bleeding. (A, B, and C) are not indicated for a client who needs to
implement thrombocytopenia precautions.
• The practical nurse (PN) is caring for a client who has been taking
prednisone (Deltasone) daily for a year. Which adverse effect should the
PN document in the client's record?
A) Photosensitvity.
B) Weight gain.
C) Loss of hair.
D) Pale skin color. -✓✓B) Weight gain.
Feedback:
,Long term use of prednisone causes fluid retention and redistribution of
fat deposition. Weight gain (B) and moon face reflect adverse effects of
long-term prednisone use and should be documented. (A, C, and D) do
not occur with treatment using prednisone.
• A female client with recurring headaches tells the practical nurse (PN)
that she has been taking at least 4 grams of acetaminophen a day. Which
laboratory studies should the PN review for this client?
A) Creatinine clearance.
B) Hepatic enzymes.
C) Coagulation values.
D) Arterial blood gases. -✓✓B) Hepatic enzymes.
Feedback:
Liver toxicity can occur when doses of acetaminophen exceed 4 grams a
day, resulting in an elevation in hepatic enzyme values (B). (A, C, and
D) do not reveal findings related to acetaminophen toxicity.
• A client receives a prescription for an oral opioid analgesic for post-
operative pain. Which adverse effect should the practical nurse (PN)
monitor for with the client?
A) Constipation.
B) Photosensitivity.
C) Decreased heart rate.
D) Frequent urination. -✓✓A) Constipation.
Feedback:
,Opioid analgesics slow peristalsis, which leads to constipation (A), a
common side effect of opiates. (B, C, and D) are not associated with
opioid analgesics.
• Which action should the practical nurse implement when administering
a buccal medication?
A) Encourage the client to swallow.
B) Administer water with medication.
C) Ensure the medication is positioned under the tongue.
D) Place the medication between the upper molar teeth and cheek. -
✓✓D) Place the medication between the upper molar teeth and cheek.
Feedback:
Buccal medications are placed between the upper molar teeth and the
cheek (D) for absorption by the capillaries of the oral mucosa. The client
should be cautioned against swallowing, not (A). Buccal medications are
not administered with water (B). (C) describes sublingual
administration.
• What assessment is most important for the practical nurse (PN) to
obtain prior to initiating medication therapy with phenelzine (Nardil) for
a client with depression?
A) Activity level.
B) Mood and affect.
C) Understanding of diet modification.
D) The client's support system. -✓✓C) Understanding of diet
modification.
, Feedback:
To prevent a potentially lethal hypertensive crisis, a tyramine-free diet
should be maintained during antidepressant therapy with Nardil, a
monoamine oxidase inhibitor (MAOI). It is most important to determine
if the client understands diet modification (C) before Nardil is initiated
to prevent consumption of foods that interact with Nardil. Although a
client's activity level (A) and mood and affect (B) should be monitored
during antidepressant therapy, it is most important that the client
understand diet modifications. The client's support system (D) and
network of family and friends is important, but the client should
understand the responsibility of dietary compliance with the medication
regimen.
• The practical nurse (PN) is unable to arouse a client who is receiving
meperidine (Demerol) for postoperative pain. The client is stuporous,
has constricted pupils, and a respiratory rate of 8 breaths/minute. Which
PRN prescription should the PN give the client?
A) Naloxone (Narcan).
B) Promethazine (Phenergan).
C) Metoclopramide (Reglan).
D) Bethanechol (Urecholine). -✓✓A) Naloxone (Narcan).
Feedback:
Narcan (A) is an opioid antagonist and should be administered to reverse
the effects of a Demerol, an opioid, overdose. (B, C, and D) are common
postoperative PRN prescriptions but are not indicated for narcotic
overdose.
PAPER Question and Answer 2026 | Complete
Exam Review Guide | Grade A+
• A male client who has been receiving an antineoplastic drug has
developed thrombocytopenia. What instructions should the practical
nurse (PN) reinforce?
A) Use suppository form of drugs.
B) Avoid large public gatherings.
C) Rise slowly when standing up.
D) Shave with an electric razor. -✓✓D) Shave with an electric razor.
Feedback:
Thrombocytopenia is a common side effect of bone marrow depression
caused by several antineoplastic agents. The client is experiencing a low
platelet count and should use an electric razor (D) to reduce his risk of
bleeding. (A, B, and C) are not indicated for a client who needs to
implement thrombocytopenia precautions.
• The practical nurse (PN) is caring for a client who has been taking
prednisone (Deltasone) daily for a year. Which adverse effect should the
PN document in the client's record?
A) Photosensitvity.
B) Weight gain.
C) Loss of hair.
D) Pale skin color. -✓✓B) Weight gain.
Feedback:
,Long term use of prednisone causes fluid retention and redistribution of
fat deposition. Weight gain (B) and moon face reflect adverse effects of
long-term prednisone use and should be documented. (A, C, and D) do
not occur with treatment using prednisone.
• A female client with recurring headaches tells the practical nurse (PN)
that she has been taking at least 4 grams of acetaminophen a day. Which
laboratory studies should the PN review for this client?
A) Creatinine clearance.
B) Hepatic enzymes.
C) Coagulation values.
D) Arterial blood gases. -✓✓B) Hepatic enzymes.
Feedback:
Liver toxicity can occur when doses of acetaminophen exceed 4 grams a
day, resulting in an elevation in hepatic enzyme values (B). (A, C, and
D) do not reveal findings related to acetaminophen toxicity.
• A client receives a prescription for an oral opioid analgesic for post-
operative pain. Which adverse effect should the practical nurse (PN)
monitor for with the client?
A) Constipation.
B) Photosensitivity.
C) Decreased heart rate.
D) Frequent urination. -✓✓A) Constipation.
Feedback:
,Opioid analgesics slow peristalsis, which leads to constipation (A), a
common side effect of opiates. (B, C, and D) are not associated with
opioid analgesics.
• Which action should the practical nurse implement when administering
a buccal medication?
A) Encourage the client to swallow.
B) Administer water with medication.
C) Ensure the medication is positioned under the tongue.
D) Place the medication between the upper molar teeth and cheek. -
✓✓D) Place the medication between the upper molar teeth and cheek.
Feedback:
Buccal medications are placed between the upper molar teeth and the
cheek (D) for absorption by the capillaries of the oral mucosa. The client
should be cautioned against swallowing, not (A). Buccal medications are
not administered with water (B). (C) describes sublingual
administration.
• What assessment is most important for the practical nurse (PN) to
obtain prior to initiating medication therapy with phenelzine (Nardil) for
a client with depression?
A) Activity level.
B) Mood and affect.
C) Understanding of diet modification.
D) The client's support system. -✓✓C) Understanding of diet
modification.
, Feedback:
To prevent a potentially lethal hypertensive crisis, a tyramine-free diet
should be maintained during antidepressant therapy with Nardil, a
monoamine oxidase inhibitor (MAOI). It is most important to determine
if the client understands diet modification (C) before Nardil is initiated
to prevent consumption of foods that interact with Nardil. Although a
client's activity level (A) and mood and affect (B) should be monitored
during antidepressant therapy, it is most important that the client
understand diet modifications. The client's support system (D) and
network of family and friends is important, but the client should
understand the responsibility of dietary compliance with the medication
regimen.
• The practical nurse (PN) is unable to arouse a client who is receiving
meperidine (Demerol) for postoperative pain. The client is stuporous,
has constricted pupils, and a respiratory rate of 8 breaths/minute. Which
PRN prescription should the PN give the client?
A) Naloxone (Narcan).
B) Promethazine (Phenergan).
C) Metoclopramide (Reglan).
D) Bethanechol (Urecholine). -✓✓A) Naloxone (Narcan).
Feedback:
Narcan (A) is an opioid antagonist and should be administered to reverse
the effects of a Demerol, an opioid, overdose. (B, C, and D) are common
postoperative PRN prescriptions but are not indicated for narcotic
overdose.
